BMA members took industrial action for the first time in almost 40 years in early summer 2012.
Not because of the Health Act, continued pay freezes or the rising tide of workload and regulation, but pensions.
A total of 79% of GP members of the BMA, on a 53% turnout, backed taking industrial action short of a strike in a landmark vote in May.
Among consultants, an even higher proportion backed action, and on 21 June GPs cancelled clinics and appointments to show their anger.
Doctors felt compelled to take action because key BMA arguments – that NHS pensions had only just undergone a major overhaul in 2008, and that the scheme delivered an annual £2bn surplus to the Treasury – were ignored by ministers.
Despite these factors, the government pressed ahead with plans to almost double the top level of pension contributions to 14.5% for high-earning doctors and to raise the NHS pension age to 68.
GP reported in January 2012 on BMA plans for a fightback, with industrial action among options on the table.
Efforts to negotiate with the DH fell apart soon afterwards and the BMA launched an online petition to press for ‘meaningful talks’ on pensions.
But when it did come to industrial action, the then health secretary Andrew Lansley warned that the general public would not ‘understand or sympathise’.
The national media was only too happy to stick to this line – a heavily critical response from the media labelled doctors as ‘selfish’ for taking action.
Plans for a second wave of strikes were duly scrapped, but the BMA has continued to warn about the risk that pensions cuts could force many GPs to quit the profession and entrench unfairness for NHS staff.
November produced the only glimmer of positive news on pensions for some time, with the BMA reacting positively to an invitation from health secretary Jeremy Hunt on pensions talks.
Mr Hunt invited the BMA and other unions to offer views on a ‘fairer contribution structure’ for NHS pensions beyond 2015. The BMA hailed the invitation as a milestone, believing it showed part of their message was getting through.
But just weeks later, in stepped chancellor George Osborne with his autumn statement to dampen any pre-Christmas cheer. From 2014/15, he said, the government will reduce the tax-free lifetime allowance for pension savings from £1.5m to £1.25m and the tax-free annual allowance from £50,000 to £40,000. Accountants warned that most GPs would be hit because tax charges would apply to anyone with an annual projected pension above £54,000 a year. The average GP pension is £60,000.